布托啡诺与右美托咪啶用于超声纤维支气管镜检查麻醉效果比较

Comparion of Butorphanol and Dexmetomidine Used for Ultrasonographic Fiberoptic Bronchoscopy

目的:比较布托啡诺与右美托咪啶用于超声纤维支气管镜检查的安全性和有效性。方法:以行超声纤维支气管镜检查的患者60例为研究对象,ASAⅠ?Ⅱ级,按完全随机法分为布托啡诺组(B组,n=30)和右美托咪啶组(D组,n=30)。检查前15 min B组患者静脉注射布托啡诺20μg/kg,D组患者持续泵注右美托咪啶0.04μg/(min·kg);检查前5 min两组均静脉靶控输注瑞芬太尼5-6 ng/ml。纤维支气管镜进入声门后右美托咪啶减至0.01?0.02μg/(min·kg),两组瑞芬太尼均减至2?3 ng/ml。比较给药前(T0)、入睡即刻(T1)、进声门后(T2)、术毕(T3)、苏醒时(T4)时间的心率(HR)、脉搏氧饱和度(SpO2)、无创血压(MAP),麻醉深度指数(NTI)、麻醉效果的评估及恶心呕吐发生率。结果:与B组比较,D组在T1?T4时MAP均明显下降、T1和T3时点NTI指数均明显降低(P均<0.05);麻醉效果无明显差异;但恶心呕吐发生率明显增高(P<0.05)。结论:布托啡诺用于超声纤维支气管镜检查中的麻醉较右美托咪啶安全有效。

Objective:To compare the safety and effect of the anesthesia method used butorphanol and dexmetomi?dine for ultrasonographic fiberoptic bronchoscopy.Methods:60 patients scheduled to performed ultrasonographic fiberop?tic bronchoscopy were divided into group B(n=30,butorphanol)and group D(n=30,dexmetomidine),butorphanol(20μg/kg)and dexmetomidine[0.04μg/(min·kg)]was administered 15 min before examine respectively.remifentanil(5?6 ng/ml)was administered 5 min before the examination.Heart rate(HR),saturation of pulse oxygen(SpO2),mean blood pressure(MBP),narcotrend index(NTI),anaesthetic assessment,nause and vomiting were compared between the two groups at different time points of before anesthesia(To),immediately after induction(T1),immediately after brenchos?copy entering glottis(T2),immediately after the broncboscopy completion(T3)and anesthesia recovery(T4).Results:Compared with group B,MBP were significantly decreased at T1?T4,the NTI were significantly lower at T1?T3,all P<0.05.The anaesthetic assessment were not significantly different(P>0.05).However,The incidence rate of nausea and vomiting was significantly lower(P<0.05).Conclusion:Safety and efficacy of butorphanol is superior to dexmedetomi?dine in ultrasonographic fiberoptic bronchoscopy.